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3a > Psychiatry: Neurodevelopment > Flashcards

Psychiatry: Neurodevelopment Flashcards

1
Q

what is ADHD ? characterised by what ? (3)

A

neurodevelopment disorder characterised by:
- inattention
- hyperactivity
- impulsiveness

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2
Q

how does ADHD often present to health care ?

A

due to poor school performance or sorptive behaviour

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3
Q

describe ADHD symptoms ? characters by the 3 domains

A
  • inattention: difficult maintaining focus on thought/ task, easily distracted, task avoidance, signore instruction, lose things, disorganised, forgetfull
  • Hyperactivity: energetic, difficulty sitting still/ withholding impulsions
  • Impulsiveness: talk excessively, blurt out answers, can’t wait turn, interrupt
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4
Q

ADHD Dx ? requirements ? how long Sx for ? Sx onset ?

A

functionally imparting inattention, hyperacitivy and or impulsiveness (in 2 or more settings) for more than 6 monts
- young at onset (<12 yrs)

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5
Q

first line ADHD managment in children ? second line

A

(6-18)
- stimulant (methylphenidate), psychoeducation, +/- behavioural therapy
- 2nd line: different class of stimulant (amphetamine)

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6
Q

how do stimulants work ind ADHD Mx ?

A

increase dopamine and NAd => improve attention + hyperactivity

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7
Q

SE of ADHD Mx ?

A

methylphendate, amphetamine salts
- SE: growth restriction, appetite suppression, insomnia, addiction

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8
Q

What is ASD ? characterised by what ? (2)

A

neurodevelopemtnal disorder characterised by:
- difficulty in social communication/interaction
- Restricted interest/activites

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9
Q

ASD Dx ?

A

difficulty in social communication + restricted interest/activity present since early childhood => impairing function (exclude other causes)

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10
Q

what are some of the social communication Sx associated with ASD ? difficulty with what ?

A
  • used of language (verbal + non-verbal) difficulties): delayed speech dev (or mute), struggle understanding + using body language/facial expression), only literal
  • difficulty with: reprocity, turn-taking and sharing
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11
Q

describe the restricted/repetitiv pattern associated with ASD ?

A

insistence upon sameness
- same food/activies
- special interest

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12
Q

what other symptoms might there be in ASD ?

A
  • sensory disturabce
  • Savantism
  • reduced cognition (I think)
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13
Q

ASD epi ?

A

0.1-2%
- M>F (x4)

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14
Q

ASD Mx ?

A
  • behavioural therapy
  • speech and language therapy
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15
Q

what is a somatisation or somatiform disorder ?

A

body based/somatic sx (pain, nausea, SOB)
- resemble physical disorder but actually psychological (no pathology)

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16
Q

what is somatic disorder ? Dx ?

A
  • somatic Sx
  • medically unexplained
  • accompanied by maladaptive thoughts + feelings: anxiety, time + energy
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17
Q

name some of the common presentation is somatic disorder ? most common ?

A

pain, fatigue, dizziness, stiffness, palpitations, N+V
- pain is actually experiences (not fake)
- GI tract most common presentation (diarrhoea, vomiting, constipation)
(chronic and impairing)

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18
Q

Somatic Symptom disorder Mx ? (3)

A
  • CBT
  • Mindfullness based therpy
  • Antidepressants
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19
Q

somatisation RF ? (3)

A
  • female
  • sexual or physical assualt
  • ACEs
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20
Q

What is illness anxiety disorder ? associated with what ? describe this

A

obsessional preoccupation that one has a medical disease
- under ocd spectrum: obsessive thought (belief that ill) => impulsive behaviour (check sings + Sx) => distress + dystfuciton => repeat

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21
Q

how illness anxiety disorder different to somatic Sx disorder ?

A

somatic Sx disorder is focus on Sx where illness anxiety is stress is not about the Sx but the disease (will make condition worse when no Dx found)

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22
Q

What is conversion disorder ? aka ? link with what ?

A

functional neurologic disorder
- clinically unexplained abnormality of nervous system brought on by stressful trigger (Sx not faked)
- link with dissociative disorders

23
Q

conversion disorder Px ?

A

similar to somatic Sx disorder however is specifically neuro
- weakness, blindness, numbness, loss of function

24
Q

conversion disorder Mx ?

A

education on disorder (but do not imply that they are lying)

25
name some conditions that present with fake presenting complaints ?
- factitious disorder - malingering
26
what is factitious disorder ?
(munchhausens) - fabricated to gain social benefits associated with the sick role (sympathy)
27
what is malingering ?
fabricated presentation to gain some external reward (liability benefits, stay in hospital)
28
What is Body dysmorphia ? associated with what condition ?
Mental fixation that specific aspects of ones appearance are flawed/deformed - OCD spectrum disorder
29
describe some of the features of body dimorphic thinking ?
entirely based on perception + not on what objective outsider would think - Ego-syntoinic, disabiling
30
how is body dysmorphia like OCD ?
obsessions: intrusive, mid based, unwanted, resistant, distressing, recurrent - compulsions: measuring, weighing, body checking - leading to distress + dysfunction
31
Body dysmorphia Mx ?
same as OCD: CBT, consider SSRI
32
what are eating disorders ? generally, causing ?
pattern of abnormal food intake that decreases someones ability to maintain adequate nutrition => physical + psychological health disorders
33
what do anorexia and bulimia have in common ?
overvalue beliefs about weight + maladaptive behaviours
34
what is anorexia nervosa ? characterised by ?
perceive to be overweight despite being underweight (often use BM < 17.5) - nervous about gaining weight (constant preoccupation) - distorted perception (body dysmorphia) - excessive exercise (+use of laxatives) - restricting calories (similar to OCD thinking again)
35
what are some of the physical manifestations of anorexia ? (9)
- fatigue - amenorrhoea - osteoporosis - cardiac arhythmias (hypokalaemia) - lanugo hair - hypotension - reduced temp - mood changes - cold
36
anorexia Epi ? M:F ? mortality ?
<0.5% F>M (x20) 20% mortality
37
wha Is bulimia nervosa ? characterised by what ?
- binge eating: eating v large amounts with no control, emotional numbness during eating, disgust post-eating - offsetting/purging (self induced vomiting) - linked to self esteem
38
what personality disorder is bulimia linked to ? anorexia ?
anorexia: OCPD bulimia: BPD
39
what are some of the effects of self induced vomiting (signs+sympotms) ?
- erosion of dental enamel - swollen salivary glands - injury on back of knuckles (Russell sign) - Kidney disease from dehydration - gastric ulcers
40
what blood gas associated with bulimia ?
metabolic alkalosis
41
bulimia Mx ? don't use what ?
CBT + SSRIs - do not use bupropion ! (increases risk of siezures)
42
What is binge eating disorder ? often triggered by what ? associated with what ?
similar to bulimia but not offset by purging => often overweight - associated with BPD - often overeat due to underlying psychological distress
43
what is ARFID ?
avoidant/restrictive food intake disorder (ARFID): tend to avoid food/ narrow selection => failure of adequate nutrition (not related to body image)
44
what is referring syndrome ? who at risk more ? (2)
occurs in Px who have been in severe nutritional defect for an extended period and then resume feeding - Px at higher risk: BMI < 20, little toe at for past 5 days (risk increases with lower BMI and more days without eating)
45
describe the pathophys of refeeding syndrome ?
cell metabolism slows during prolonged malnutrition => feed => starved cells process glucose + protein + fats => electrolyte abnormalities
46
what electrolyse abnormalities are there in referring ? (3) risk of what ? (3)
- hypomagnesia - hypokalaemia - hypophosphataemia risk of: cardiac arrhythmias, fluid imbalances, heart failure
47
refeeding syndrome Mx ?
- slowly reindorodece food + restrict calories - MG, K, Pohs + glucose monitoring - fluid balance monitoring - ECG monitoring - Supplementation (B vits, Thiamine)
48
What is adjustment disorder ?
depressive and/or anxious sx that occur after major life stressors (divorce, lose job) - often subsyndromal depression (<5/9)
49
adjustment disorder Mx ?
supportive therapy
50
what is catatonia ?
abnormal mental state characterised by changes in consciousness + behaviour
51
catatonia presentaiton ?
- lethargy (sedated despite eyes open) - immobility (lack of movement => malnutrition + dehydration) - mutism (absent verbal communication) - positioning (holding abnormal positions) - echolalia, echopraxia
52
what conditions is catatonia associated with ?
- BP - MDD - schizophrenia
53
catatonia Mx ? (3) gold standard
- benzos - ECT (gold standard but start with benzos as less invasive) - discontinue AP

3a (43 decks)

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